Relaxation guided imagery reduces motor fluctuations in Parkinson's disease

Background: Motor fluctuations in Parkinson's disease (PD) cause major disabling symptoms.

Objective: We aimed to assess the efficacy of relaxation guided imagery in PD patients with motor fluctuation.

Methods: In a prospective pilot, case cohort, PD patients underwent (i) a relaxation session with relaxation guided imagery, and (ii) a control session of relaxing music. Three-day diaries were completed at baseline and after each intervention. Subsequently, patients received discs for home listening-a relaxation guided imagery disc and a relaxing music disc. After three months the patients were interviewed by phone.

Results: Twenty one PD patients participated and 19 completed this study. There was a significant increase in the percent of "on" time after listening to the relaxation guided imagery disc as compared with baseline (from 47.7% to 62.8%, 95% CI 5.26-25.03, p = 0.005). Relaxing music caused no significant change in percent of "on" time from baseline (from 47.7% to 53.0%, p = 0.161). Although all sessions were performed in "on" state, there was a significant decrease in UPDRS motor subscores after each of the two sessions as compared with the UPDRS score before the session (relaxation guided imagery mean reduction -3.81 p = 0.0002 and after relaxing music mean reduction -1.95, p = 0.001), significantly more so after the relaxation guided imagery (p = 0.020). After 3 months listening to the relaxation guided imagery disc increased "on" time from baseline by 12.6% (95% CI 3.19-28.39, p = 0.111) but this did not reach statistical significance.

Conclusion: In this pilot study we showed that relaxation guided imagery is a promising treatment for PD.